Mental disorders
For individual mental disorders see: List of mental disorders and Category:Mental disorders Mental disorder or mental illness are terms used to refer a psychological or physiological pattern that occurs in an individual and is usually associated with distress or disability that is not expected as part of normal development or culture. The recognition and understanding of mental disorders has changed over time. Definitions, assessments, and classifications of mental disorders can vary, but guideline criterion listed in the ICD, DSM and other manuals are widely accepted by mental health professionals. Categories of diagnoses in these schemes may include mood disorders, anxiety disorders, psychotic disorders, eating disorders, developmental disorders, personality disorders, and many other categories. In many cases there is no single accepted or consistent cause of mental disorders, although they are widely understood in terms of a diathesis-stress model and biopsychosocial model. Mental disorders have been found to be common, with over a third of people in most countries reporting sufficient criteria at some point in their life. Mental health services may be based in hospitals or in the community. Mental health professionals diagnose individuals using different methodologies, often relying on case history and interview. Psychotherapy and psychiatric medication are two major treatment options, as well as supportive interventions. Treatment may be involuntary where legislation allows. A number of movements campaign for changes to mental health services and attitudes, including the Consumer/Survivor Movement. There are widespread problems with stigma and discrimination. History A number of mental disturbances, such as melancholy, hysteria and phobia, were described long ago in Ancient Greece and Rome, while others such as schizophrenia may not have been recognized.K. Evans, J. McGrath, R. Milns (2003) Searching for schizophrenia in ancient Greek and Roman literature: a systematic review Acta Psychiatrica Scandinavica 107 (5), 323–330. Hippocrates considered the idea that mental illness may be related to biology.Stong, C. (2005). The Evolution of NeuroPsychiatry. Neuropsychiatry Reviews, 6. Psychiatric theories and treatments for mental illness developed in Islamic medicine in the Middle East, notably from the 8th century at the Baghdad Hospital under the physician Al-Razi or Rhazes. Medieval Europe had focused on demonic possession as the explanation of aberrant behavior.Kroll J., & Bachrach, B. (1984). Sin and mental illness in the Middle Ages. Psychological Medicine, 14, 507-514. Paracelsus used the word lunatic to describe behavior thought to be caused by the lunar effect.Delgado, J.M., Doherty, A.M.S., Ceballos, R.M., Erkert, H.G. (2000). Moon Cycle Effects on Humans: Myth or Reality? Salud Mental, 23, 33-39. Many other terms for mental disorder that found their way into everyday use have been traced to initial use in the 16th and 17th centuries. Dalby JT. (1993) Terms of Madness: Historical Linguistics. Comprehensive Psychiatry 34,392-395. Shakespeare and his contemporaries frequently depicted mental disorders in their plays. Dalby JT. (1997) Elizabethan madness: On London's stage. Psychological Reports 81, 1331-1343. Conditions of "shell shock" came to be recognized in war veterans. Homosexuality was viewed as a mental illness. From the early study of mental illness through individuals such as Philippe Pinel, Sigmund Freud, and Alois Alzheimer, much has changed in the development and understanding of mental illness and continues to change today. At the start of the 20th century there were only a dozen officially recognized mental health conditions. . By 1952 there were 192 and the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV) today lists 374. Classification The definition and classification of mental disorder is a key issue for the mental health professions and for users and providers of mental health services. Most international clinical documents use the term "mental disorder" rather than "mental illness". There is no single definition and the inclusion criteria are said to vary depending on the social, legal and political context. In general, however, a mental disorder has been characterized as a clinically significant behavioral or psychological pattern that occurs in an individual and is usually associated with distress, disability or increased risk of suffering. There is often a criterion that a condition should not be expected to occur as part of a person's usual culture or religion. The term "serious mental illness" (SMI) is sometimes used to refer to more severe and long-lasting disorder. A broad definition can cover mental disorder, mental retardation, personality disorder and substance dependence. The phrase "mental health problems" may be used to refer only to milder or more transient issues. There are currently two widely established systems that classify mental disorders - Chapter V of the International Classification of Diseases (ICD-10), produced by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) produced by the American Psychiatric Association (APA). Both list categories of disorder and provide standardized criteria for diagnosis. They have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be in use more locally, for example the Chinese Classification of Mental Disorders. Other manuals may be used by those of alternative theoretical persuasions, for example the Psychodynamic Diagnostic Manual. Some approaches to classification do not employ distinct categories based on cut-offs separating the abnormal from the normal. They are variously referred to as spectrum, continuum or dimensional systems. There is a significant scientific debate about the relative merits of a categorical or a non-categorical system. There is also significant controversy about the role of science and values in classification schemes, and about the professional, legal and social uses to which they are put. Disorders There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered.Gazzaniga, M.S., & Heatherton, T.F. (2006). Psychological Science. New York: W.W. Norton & Company, Inc.WebMD, Inc. (2005, July 01). Mental Health: Types of Mental Illness. Retrieved April 19, 2007, from http://www.webmd.com/mental-health/mental-health-types-illnessUnited States Department of Health & Human Services. (1999). Overview of Mental Illness. Retrieved April 19, 2007NIMH (2005) Teacher's Guide: Information about Mental Illness and the Brain Curriculum supplement from The NIH Curriculum Supplements Series The state of anxiety or fear can become disordered, so that it is unusually intense or generalized over a prolonged period of time. Commonly recognized categories of anxiety disorders include specific phobia, Generalized anxiety disorder, Social Anxiety Disorder, Panic Disorder, Agoraphobia, Obsessive-Compulsive Disorder, Post-traumatic stress disorder. Relatively long lasting affective states can also become disordered. Mood disorder involving unusually intense and sustained sadness, melancholia or despair is know as Clinical depression (or Major depression), and may more generally be described as Emotional dysregulation. Milder but prolonged depression can be diagnosed as dysthymia. Bipolar disorder involves abnormally "high" or pressured mood states, known as mania or hypomania, alternating with normal or depressed mood. Whether unipolar and bipolar mood phenomena represent distinct categories of disorder, or whether they usually mix and merge together along a dimension or spectrum of mood, is under debate in the scientific literature.Akiskal, HS. & Benazzi, F. (2006) The DSM-IV and ICD-10 categories of recurrent (major) depressive and bipolar II disorders: evidence that they lie on a dimensional spectrum. Journal of Affective Disorders May;92(1):45-54. Patterns of belief, language use and perception can become disordered. Psychotic disorders centrally involving this domain include Schizophrenia and Delusional disorder. Schizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the traits associated with schizophrenia but without meeting cut-off criteria. The fundamental characteristics of a person that influence his or her cognitions, motivations, and behaviors across situations and time - can be seen as disordered due to being abnormally rigid and maladaptive. Categorical schemes list a number of different personality disorders, such as those classed as eccentric (e.g. Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder), those described as dramatic or emotional (Antisocial personality disorder, Borderline personality disorder, Histrionic personality disorder, Narcissistic personality disorder) or those seen as fear-related (Avoidant personality disorder, Dependent personality disorder, Obsessive-compulsive personality disorder). There may be an emerging consensus that personality disorders, like personality traits in the normal range, incorporate a mixture of more acute dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable.Lee Anna Clark (2007) Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization Annual Review of Psychology Vol. 58: 227-257 Non-categorical schemes may rate individuals via a profile across different dimensions of personality that are not seen as cut off from normal personality variation, commonly through schemes based on the Big Five personality traits.Morey LC, Hopwood CJ, Gunderson JG, Skodol AE, Shea MT, Yen S, Stout RL, Zanarini MC, Grilo CM, Sanislow CA, McGlashan TH. (2006) Comparison of alternative models for personality disorders. Psychol Med. Nov 23;:1-12 Other disorders may involve other attributes of human functioning. Eating practices can be disordered, at least in relatively rich industrialized areas, with either compulsive over-eating or under-eating or binging. Categories of disorder in this area include Anorexia nervosa and Bulimia nervosa or Binge eating disorder. Sleep disorders such as Insomnia also exist and can disrupt normal sleep patterns. Sexual and gender identity disorders, such as Dyspareunia or Gender identity disorder or ego-dystonic homosexuality. People who are abnormally unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others, may be classed as having an impulse control disorder, including various kinds of Tic disorders such as Tourette's Syndrome, and disorders such as Kleptomania (stealing) or Pyromania (fire-setting). Substance-use disorders include Substance abuse disorder. Addictive gambling may be classed as a disorder. Inability to sufficiently adjust to life circumstances may be classed as an Adjustment disorder. The category of adjustment disorder is usually reserved for problems beginning within three months of the event or situation and ending within six months after the stressor stops or is eliminated. People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classed as having a Dissociative identity disorder, such as Depersonalization disorder or Dissociative Identify Disorder itself (which has also been called multiple personality disorder, or "split personality".). Factitious disorders, such as Munchausen syndrome, also exist where symptoms are experienced and/or reported for personal gain. Disorders appearing to originate in the body, but thought to be mental, are known as somatoform disorders, including Somatization disorder. There are also disorders of the perception of the body, including Body dysmorphic disorder. Neurasthenia is a category involving somatic complaints as well as fatigue and low spirits/depression, which is officially recognized by the ICD-10 but not by the DSM-IV.Gamma A, Angst J, Ajdacic V, Eich D, Rossler W. (2007) The spectra of neurasthenia and depression: course, stability and transitions. Eur Arch Psychiatry Clin Neurosci. Mar;257(2):120-7. Memory or cognitive disorders, such as amnesia or Alzheimer's disease exist. Some disorders are thought to usually first occur in the context of early childhood development, although they may continue into adulthood. The category of Specific developmental disorder may be used to refer to circumscribed patterns of disorder in particular learning skills, motor skills, or communication skills. Disorder which appears more generalized may be classed as pervasive developmental disorders (PDD) also known as autism spectrum disorders (ASD); these include autism, Asperger's, Rett syndrome, childhood disintegrative disorder and other types of PDD whose exact diagnosis may not be specified. Other disorders mainly or first occurring in childhood include Reactive attachment disorder; Separation Anxiety Disorder; Oppositional Defiant Disorder; Attention Deficit Hyperactivity Disorder. Causes Numerous factors have been linked to the development of mental disorders. In many cases there is no single accepted or consistent cause. A common view is that disorders often result from genetic vulnerabilities combining with environmental stressors (Diathesis-stress model). An eclectic or pluralistic mix of models may be used to explain particular disorders. The primary paradigm of contemporary mainstream Western psychiatry is said to be the biopsychosocial (BPS) model - incorporating biological, psychological and social factors - although this may not be applied in practice. Biopsychiatry has tended to follow a biomedical model, focusing on "organic" or "hardware" pathology of the brain. Psychoanalytic theories have been popular but are now less so. Evolutionary psychology may be used as an overall explanatory theory. Attachment theory is another kind of evolutionary-psychological approach sometimes applied in the context for mental disorders. A distinction is sometimes made between a "medical model" or a "social model" of disorder and related disability. Genetic studies have indicated that genes often play an important role in the development of mental disorders, via developmental pathways interacting with environmental factors. The reliable identification of connections between specific genes and specific categories of disorder has proven more difficult. Environmental events surrounding pregnancy and birth have also been implicated. Traumatic brain injury may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health. Abnormal functioning of neurotransmitter systems has been implicated, including serotonin, norepinephrine, dopamine and glutamate systems. Differences have also been found in the size or activity of certain brains regions in some cases. Psychological mechanisms have also been implicated, such as cognitive and emotional processes, personality, temperament and coping style. Social influences have been found to be important, including abuse, bullying and other negative or stressful life experiences. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures. Diagnosis Many mental health professionals, particularly psychiatrists, seek to diagnose individuals by ascertaining their particular mental disorder. Some professionals, for example some clinical psychologists, may avoid diagnosis in favor of other assessment methods such as formulation of a client's difficulties and circumstances.Kinderman, P. and Lobban, F. (2000) Evolving formulations: Sharing complex information with clients. Behavioural and Cognitive Psychotherapy, 28(3), 307-310. The majority of mental health problems are actually assessed and treated by family physicians during consultations, who may refer on for more specialist diagnosis in acute or chronic cases. Routine diagnostic practice in mental health services typically involves an interview (which may be referred to as a mental status examination), where judgements are made of the interviewee's appearance and behavior, self-reported symptoms, mental health history, and current life circumstances. The views of relatives or other third parties may be taken into account. A physical examination to check for ill health or the effects of medications or other drugs may be conducted. Psychological testing is sometimes used via paper-and-pen or computerized questionnaires, which may include algorithms based on ticking off standardized diagnostic criteria, and in relatively rare specialist cases neuroimaging tests may be requested, but these methods are more commonly found in research studies than routine clinical practice.HealthWise (2004) Mental Health Assessment. Yahoo! HealthDavies, T. (1997) ABC of mental health: Mental health assessment British Medical Journal 314:1536 Time and budgetary constraints often limit practicing psychiatrists from conducting more thorough diagnostic evaluations.Kashner TM, Rush AJ, Surís A, Biggs MM, Gajewski VL, Hooker DJ, Shoaf T, Altshuler KZ. (2003) Impact of structured clinical interviews on physicians' practices in community mental health settings. Psychiatr Serv. 2003 May;54(5):712-8. PMID 12719503 It has been found that most clinicians evaluate patients using an unstructured, open-ended approach, with limited training in evidence-based assessment methods, and that inaccurate diagnosis may be common in routine practice.Shear MK, Greeno C, Kang J, Ludewig D, Frank E, Swartz HA, Hanekamp M. (2000) Diagnosis of nonpsychotic patients in community clinics. ''Am J Psychiatry. Apr;157(4):581-7 PMID 10739417 Comorbidity is very usual with mental disorders, i.e. same person can suffer one or more disorder. The work for fifth version of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) DSM-V Prelude Project website has raised some questions about dimensional diagnostic criteria compared to categorical diagnostic criteria. Journal of Abnormal Psychology (Vol 114, Issue 4) Journal of Abnormal Psychology - Vol 114, Issue 4 devoted a whole issue to discuss about categorical and dimensional diagnostic criteria. In short it the argument is that diagnosis of mental disorder can be based on several overlapping dimensions and not categorical and/or two-dimensional classes. One possibility in diagnosis is to have several (>2) dimensions overlapping and that it is harder to describe. In the following picture idea is that multiple dimension lines are crossed with one diagnostic line and the combination of crossing points is basis for a diagnosis. In practical clinical settings it might be problematic to find several disorders in different dimensions and also differentiate the position of specific disorder in its dimensional axis like the picture indicates. Treatment Mental health services may be based in hospitals, clinics or the community. Often an individual may engage in different treatment modalities. They may be under case management (sometimes referred to as "service coordination"), use inpatient or day treatment, utilize a psychosocial rehabilitation program, and/or take part in an Assertive Community Treatment program. Individuals may be treated against their will in some cases, especially if assessed to be at high risk to themselves or others. Services in some countries are increasingly based on a Recovery model that supports an individual's journey to regain a meaningful life. Psychotherapy A major option for many mental disorders is psychotherapy. There are several main types. Cognitive behavioral therapy (CBT) is widely used and is based on modifying the patterns of thought and behavior associated with a particular disorder. Psychoanalysis, addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. Systemic therapy or family therapy is sometimes used, addressing a network of signicant others as well as an individual. Some psychotherapies are based on a humanistic approach. There are a number of specific therapies used for particular disorders, which may be offshoots or hybrids of the above types. Mental health professionals often employ an eclectic or integrative approach. Much may depend on the therapeutic relationship, and there may be problems with trust, confidentiality and engagement. Medication A major option for many mental disorders is psychiatric medication. There are several main groups. Antidepressants are used for the treatment of clinical depression as well as often for anxiety and other disorders. Anxiolytics are used for anxiety disorders and related problems such as insomnia. Mood stabilizers are used primarily in bipolar disorder, mainly targeting mania rather than depression. Antipsychotics are used for psychotic disorders, notably for positive symptoms in schizophrenia. Stimulants are commonly used, notably for ADHD. Despite the different conventional names of the drug groups, there can be considerable overlap in the kinds of disorders for which they are actually indicated. There may also be off-label use. There can be problems with adverse effects and adherence. Other Electroconvulsive therapy (ECT) is sometimes used in severe casees when other interventions have failed. Psychosurgery is no longer generally used. Psychoeducation may be used to provide people with the information to understand and manage their problems. Creative therapies are sometimes used, including music therapy, art therapy or drama therapy. Lifestyle adjustments and supportive measures are often used, including peer support, self-help and supported housing or employment. Some advocate dietary supplements. Many things have been found to help at least some people. A placebo effect may play a role in any intervention. Prognosis There is substantial variation over time between disorders, and between individuals. Functional ability may also vary across different domains. There may be remission of symptoms, but also relapse. Rates of recovery vary. A number of individual and social factors have been linked to prognosis. Despite often being characterized in purely negative terms, mental disorders can involve above-average creativity, non-conformity, goal-striving, meticulousness, or empathy. The public perception of the level of disability associated with mental disorders can change.Ferney, V. (2003) The Hierarchy of Mental Illness: Which diagnosis is the least debilitating? New York City Voices Jan/March Prevalence WHO estimated that about 450 million people worldwide currently suffer from some form of mental or behavioural disorder.WHO | The world health report One in four people will suffer from mental illness at some time in life, according to a report from the WHO.Mental Health Care in the Developing WorldMental problems 'hit one in four' Professions and fields A number of professions have developed that specialise in the treatment of mental disorders, including the medical speciality of psychiatry (including psychiatric nursing)A, N.C. (1997). What is Psychiatry? The American Journal of Psychiatry, 154, 591-593.University of Melbourne. (2005, August 19). What is Psychiatry?. Retrieved April 19, 2007, from http://www.psychiatry.unimelb.edu.au/info/what_is_psych.htmlCalifornia Psychiatric Association. (2007, February 28). Frequently Asked Questions About Psychiatry & Psychiatrists. Retrieved April 19, 2007, from http://www.calpsych.org/publications/cpa/faqs.html, the division of psychology known as clinical psychologyAmerican Psychological Association, Division 12, http://www.apa.org/divisions/div12/aboutcp.html, Social WorkGolightley, M. (2004) Social work and Mental Health Learning Matters, UK, as well as Mental Health Counselors, Marriage and Family Therapists, Psychotherapists, Counselors and Public Health professionals. Those with personal experience of using mental health services are also increasingly involved in researching and delivering mental health services and working as mental health professionals.Goldstrom ID, Campbell J, Rogers JA, et al (2006) National estimates for mental health mutual support groups, self-help organizations, and consumer-operated services. Administration and Policy in Mental Health and Mental Health Services Research, 33:92–102The Joseph Rowntree Foundation (1998) The experiences of mental health service users as mental health professionalsChamberlin J. (2005) User/consumer involvement in mental health service delivery. Epidemiol Psichiatr Soc. Jan-Mar;14(1):10-4. PMID 15792289Terence V. McCann, John Baird, Eileen Clark, Sai Lu (2006) Beliefs about using consumer consultants in inpatient psychiatric units International Journal of Mental Health Nursing 15 (4), 258–265. The different clinical and scientific perspectives draw on diverse fields of research and theory, and different disciplines may favor differing models, explanations and goals.Rogers, A. & Pilgram, D. (2005) A Sociology of Mental Health and Illness, Open University Press, 3rd Edition. ISBN 0335215831 Movements The Consumer/Survivor Movement (also known as user/survivor movement) is made up of individuals (and organizations representing them) who are clients of mental health services or who consider themselves "survivors" of mental health services. The movement campaigns for improved mental health services and for more involvement and empowerment within mental health services, policies and wider society.Everett, B. (1994) Something is happening: the contemporary consumer and psychiatric survivor movement in historical context. Journal of Mind and Behavior, 15:55–7Rissmiller DJ & Rissmiller JH (2006) Evolution of the antipsychiatry movement into mental health consumerism. Psychiatric Services, Jun;57(6):863-6.Oaks, D. (2006) The Evolution of the Consumer Movement Psychiatric Services 57:1212 Patient advocacy organizations have expanded with increasing deinstitutionalization in developed countries, working to challenge the stereotypes, stigma and exclusion associated with psychiatric conditions. An antipsychiatry movement fundamentally challenges mainstream psychiatric theory and practice, including the reality or utility of psychiatric diagnoses of mental illnesses.The Antipsychiatry Coalition. (2005, November 26). The Antipsychiatry Coalition. Retrieved April 19, 2007, from www.antipsychiatry.orgAnthony Paul O'Brien, Martin Woods, Christine Palmer (2001) The emancipation of nursing practice: Applying anti-psychiatry to the therapeutic community. Australian and New Zealand Journal of Mental Health Nursing 10 (1), 3–9. Weitz D. (2003) Call me antipsychiatry activist--not "consumer" Ethical Hum Sci Serv. Spring;5(1):71-2. PMID 15279009 Laws and policies Three quarters of countries around the world have mental health legislation. Compulsory admission to mental health facilities (also known as Involuntary commitment or sectioning), is a controversial topic. From some points of view it can impinge on personal liberty and the right to choose, and carry the risk of abuse for political, social and other reasons; from other points of view, it can potentially prevent harm to self and others, and assist some people in attaining their right to healthcare when unable to decide in their own interests.World Health Organization (2005) WHO Resource Book on Mental Health: Human rights and legislation ISBN 924156282 (PDF) All human-rights orientated mental health laws require proof of the presence of a mental disorder as defined by internationally accepted standards, but the type and severity of disorder that counts can vary in different jurisdictions. The two most often utilized grounds for involuntary admission are said to be serious likelihood of immediate or imminent danger to self or others, and the need for treatment. Applications for someone to be involuntarily admitted may usually come from a mental health practitioner, a family member, a close relative, or a guardian. Human-rights-orientated laws usually stipulate that independent medical practitioners or other accredited mental health practitioners must examine the patient separately and that there should be regular, time-bound review by an independent review body. An individual must be shown to lack the capacity to give or withhold informed consent (i.e. to understand treatment information and its implications). Proxy consent (also known as substituted decision-making) may be given to a personal representative, a family member or a legally appointed guardian, or patients may have been able to enact an advance directive as to how they wish to be treated. The right to supported decision-making may also be included in legislation.Manitoba Family Services and Housing. The Vulnerable Persons Living with a Mental Disability Act, 1996 Involuntary treatment laws may be extended to those living in the community, for example Community Treatment Orders (CTOs) are used in New Zealand, Australia and 38 states in the US and are being planned in the UK.The Big Question: Will the new mental health Bill make Britain a safer place? The World Health Organization reports that in many instances national mental health legislation takes away the rights of persons with mental disorders rather than protecting rights, and is often outdated. In 1991, the United Nations adopted the Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, which established minimum human rights standards of practice in the mental health field. In 2006 the UN formally agreed the Convention on the Rights of Persons with Disabilities to protect and enhance the rights and opportunities of disabled people, including those with psychosocial disabilitiesENABLE website UN section on disability The term insanity, sometimes used colloquially as a synonym for mental illness, is often used technically as a legal term. Perception and discrimination Media Media coverage of mental illness comprises predominantly negative depictions, for example, of incompetence, violence or criminality, with far less coverage of positive issues such as accomplishments or human rights issues.Coverdate, J., Nairn, R. & Claasen, D. (2001) Depictions of mental illness in print media: a prospective national sample Australian and New Zealand Journal of Psychiatry, 36 (5), 697–700.Edney, RD. (2004) Mass Media and Mental Illness: A Literature Review Canadian Mental Health AssociationDiefenbach, D.L. (1998) The portrayal of mental illness on prime-time television Journal of Community Psychology Vol 25, Issue 3, Pages 289-302 Such negative depictions, including in children's cartoons, are thought to contribute to stigma and negative attitudes in the public and in those with mental health problems themselves, although more sensitive or serious cinematic portrayals have increased in prevalence.Sieff, E. (2003) Media frames of mental illnesses: The potential impact of negative frames Journal of Mental Health, Vol 12(3) pp. 259-269Wahl, O.F. (2003) News Media Portrayal of Mental Illness: Implications for Public Policy American Behavioral Scientist Vol. 46, No. 12, 1594-1600 General public The general public have been found to hold a strong stereotype of dangerousness and desire for social distance from individuals described as mentally ill.Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. (1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health. Sep;89(9):1328-33. Japan has been reported to have more negative attitudes than Australia, although stigma appears common in both countries.Griffiths KM, Nakane Y, Christensen H, Yoshioka K, Jorm AF, Nakane H. (2006) Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry. May 23;6:21. Violence The public fear of violence due to mental illness is a contentious topic. One US national survey indicated that a far higher percentage of Americans rated individuals described as displaying the characteristics of a mental disorder (for example Schizophrenia or Substance Use Disorder) as "likely to do something violent to others" compared to those described as being 'troubled'.Pescosolido BA, Monahan J, Link BG, Stueve A, Kikuzawa S. (1999) The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health. Sep;89(9):1339-45. Research indicates, on balance, a higher than average number of violent acts by some individuals with certain diagnoses, notably antisocial or psychopathic personality disorders, but conflicting findings about specific symptoms (for example links between psychosis and violence in community settings) - but the mediating factors of such acts are most consistently found to be mainly socio-demographic and socio-economic factors such as being young, male, of lower socio-economic status and, in particular, substance abuse (including alcohol).Stuart, H. (2003) Violence and mental illness: an overview. '' World Psychiatry. June; 2(2): 121–124Steadman HJ, Mulvey EP, Monahan J, Robbins PC, Appelbaum PS, Grisso T, Roth LH, Silver E. (1998) Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry. May;55(5):393-401. Findings consistently indicate that it is many times more likely that people diagnosed with a serious mental illness living in the community will be the victim rather than the perpetrator of violence.Brekke JS, Prindle C, Bae SW, Long JD (2001). Risks for individuals with schizophrenia who are living in the community. Psychiatric Services. Oct;52(10):1358–66. PMID 11585953 Violence by or against individuals with mental illness typically occurs in the context of complex social interactions (including in atmosphere of mutually high "expressed emotion"), including within a family setting,Solomon, PL., Cavanaugh, MM., Gelles, RJ. (2005) Family Violence among Adults with Severe Mental Illness. Trauma, Violence, & Abuse, Vol. 6, No. 1, 40-54 as well as being an issue in healthcare settingsChou, KR., Lu, RB., Chang, M. (2001) Assaultive behavior by psychiatric in-patients and its related factors. Journal of Nursing Research. Dec;9(5):139-51 and the wider community.B. Lögdberg, L.-L. Nilsson, M. T. Levander, S. Levander (2004) Schizophrenia, neighbourhood, and crime. Acta Psychiatrica Scandinavica, 110(2) Page 92. Employment Employment discrimination is reported to play a significant part in the high rate of unemployment among those with a diagnosis of mental illnessHeather Stuart (2006) Mental Illness and Employment Discrimination Current Opinion in Psychiatry 19(5):522-526. Schemes to combat stigma have been prioritized by global and national psychiatric organizations, but their methods and outcomes have been criticized as counterproductive.Read, J., Haslam, N., Sayce, L., Davies, E. (2006) Prejudice and schizophrenia: a review of the 'mental illness is an illness like any other' approach Acta Psychiatr Scand. Nov;114(5):303-18 See also * Adaptive behavior * Adjustment disorders * Affective disorders * Alexithymia * Anti-psychiatry * Anxiety disorders * Attention deficit disorder * Attention deficit behavior with hyperactivity * Autism * Behavior disorders * Borderline states * Brain disorders * Chronic mental illness * Chronicity (disorders) * Comorbidity * Congenital disorders * Consciousness disturbances * Defense mechanisms * Dementia * Disease course * Dissociative disorders * Eating disorders * Elective mutism * Emotional adjustment * Emotional dysregulation * Ethnospecific disorders * Factitious disorders * Gender identity disorder * Homeless mentally ill * Hysteria * Impulse control disorders * Insanity defence * Koro * Memory disorders * Mental disorders and gender * Mental disorders diagnosed in childhood * Mental disorder due to general medical conditions * Mental disorder defence * Mental disorder in later life * Mental health * Mental illness (Attitudes towards) * Mentally ill offenders * Mental order * Mental retardation * Neurosis * Organic brain syndromes * Perceptual disturbances * Paraphilias * Personality disorders * Personality processes * Personality disorders * Pervasive developmental disorders * Psuedodementia * Predisposition * Psychiatric patients * Psychiatric symptoms * Psychodiagnosis * Psychopathology * Psychosis * Recovery (disorders) * Relapse(disorders) * Remission (disorders) * Research diagnostic criteria * Severity (disorders) * Sexual function disturbances * Schizoeffective disorder * Schizophrenogenic family * Sleep disorders * Structured clinical interview * Structured Clinical Interview for DSM-IV ''(SCID) * Special needs * Suicide * Susceptibility (disorders) * Symptoms * Syndromes * Thought disturbances * Toxic disorders * Trauma model of mental disorders * Treatment resistance disorders * Work related illnesses Spoken Psychology Wiki References Further reading * * Roy Porter, Madness. A Brief History, Oxford University Press 2003 * Wiencke, Markus (2006) Schizophrenie als Ergebnis von Wechselwirkungen: Georg Simmels Individualitätskonzept in der Klinischen Psychologie. In David Kim (ed.), Georg Simmel in Translation: Interdisciplinary Border-Crossings in Culture and Modernity (pp. 123-155). Cambridge Scholars Press, Cambridge, ISBN 1-84718-060-5 External links Government sites * MentalHealthCommission.gov - 'Interim Report of the President's New Freedom Commission on Mental Health' (United States) * NIMH.NIH.gov - 'Working to improve mental health through biomedical research on mind, brain, and behavior', National Institute of Mental Health (United States) * NIMHE.org.uk - 'Responsible for supporting the implementation of positive change in mental health and mental health services', National Institute for Mental Health (United Kingdom) * kc.NIMHE.org.uk - 'Joined up knowledge sharing for mental health service improvement', NIMH (UK) * http://www.whatadifference.org - 'United States National Mental Health Anti-Stigma Campaign' History and professional specialties * OhioU.edu - 'The History of Mental Illness' Ohio University, The Ridges * Plato.stanford.edu - 'Mental Illness', Stanford Encyclopedia of Philosophy Compiled mental health news and resources * NAMI.org - 'In The News', National Alliance for the Mentally Ill (NAMI California) * SeeMeScotland.org - Scottish mental health awareness campaign * The Canadian Mental Health Association * National Mental Health Consumers' Self-Help Clearinghouse * National Mental Health Association * BasicNeeds International Mental Health charity, which shows the international dimension of mental health provision Category:Abnormal psychology Category:Disability Category:Medical ethics Category:Mental disorders Category:Mental health Category:Mental illness diagnosis by DSM and ICD Category:Psychiatry Category:Psychological conditions Category:Clinical psychology Category:Disorders --> zh-min-nan:Cheng-sîn-pēⁿ cs:Duševní porucha da:Psykisk sygdom de:Geisteskrankheit es:Enfermedad mental eu:Buruko gaitza fr:Maladie mentale gl:Enfermidade mental ko:정신과 질환 he:הפרעה נפשית lt:Psichikos sutrikimas nl:Psychische aandoening ja:精神疾患 no:Psykisk lidelse pl:Zaburzenie psychiczne ro:Boală mentală ru:Психическое расстройство simple:Mental illness sk:Duševná choroba sl:Duševna motnja sr:Ментални поремећај sh:Duševna bolest zh:心理疾病